Elsevier

Appetite

Volume 105, 1 October 2016, Pages 232-241
Appetite

The effect of low parental warmth and low monitoring on disordered eating in mid-adolescence: Findings from the Australian Temperament Project

https://doi.org/10.1016/j.appet.2016.05.015Get rights and content

Abstract

Objective

To investigate the interactions between low parental warmth and monitoring at age 13–14 years and disordered eating attitudes and behaviours at age 15–16 years.

Method

Data on 1300 (667 females) adolescents and their parents were drawn from The Australian Temperament Project (ATP), a 30 year (15 wave) population based longitudinal study of social-emotional development. Parent participants completed surveys on parenting practices in late childhood, and adolescent participants reported disordered eating using the drive for thinness and bulimia subscales of the Eating Disorder Inventory (EDI) and an additional body dissatisfaction scale. Interaction was examined on the additive scale by estimating super-additive risk; i.e., risk in excess of the sum of individual risks.

Results

For boys, neither parental warmth or monitoring, nor their interaction, was related to disordered eating. For girls, low parental warmth (alone) was associated with bulimic behaviours. In contrast, exposure to both low monitoring and warmth was associated with ∼3½-fold, ∼4-fold and ∼5-fold increases in the odds of reporting body dissatisfaction, drive for thinness and bulimia, respectively. For body dissatisfaction and drive for thinness, risk associated with joint exposure exceeded the sum of individual risks, suggesting an additive interaction between parenting styles.

Conclusion

Further investment in family-level interventions that focus on promoting parental monitoring behaviour and a warm parent-child relationship remain important strategies for preventing a range of disordered eating behaviours in adolescents.

Introduction

Eating disorders have a complex aetiology, involving interactions between biological, social, and environmental factors at critical developmental stages (Culbert et al., 2015, Jacobi et al., 2004). Preclinical patterns of disordered eating attitudes and behaviours generally emerge during the peri-pubertal period and may subsequently develop into full eating disorders by adolescence or early adulthood (Herpertz-Dahlmann, Buhren, & Remschmidt, 2013). There remains uncertainty about the early determinants of disordered eating behaviours, because few longitudinal studies of child and adolescent development have captured eating pathology. Some studies (e.g. Agras et al., 2007, Berge et al., 2010, Zubatsky et al., 2015) have suggested that particular parenting practices may predict subsequent eating problems. The present study uses unique developmental data from a large Australian cohort study, to examine relationships between parents’ descriptions of their warmth and monitoring parenting styles and their adolescent’s self-reports of disordered eating behaviours and symptoms two years later.

Parenting behaviours are commonly conceptualized on two dimensions: (a) the extent to which parents nurture their child (i.e., “responsiveness/warmth”) and (b) the degree to which parents monitor their child (i.e., “aware of their child’s daily activities and whereabouts”) (Baumrind, 1975). The parent-child relationship, in particular, family interaction styles typified by high levels of conflict and enmeshment and low levels of cohesion and warmth, have been associated with clinical eating disorders (Tetley, Moghaddam, Dawson, & Rennoldson, 2014) and disordered eating in community samples (Horesh et al., 2015, Loth et al., 2014). Inconsistent findings have however also been observed, with a few studies revealing only a weak or no relationship between parenting practices and subsequent eating pathology (Hautala et al., 2011, Krug et al., 2015). It should also be noted, that most studies are cross-sectional or retrospective in design (limiting causal inference) and based on convenience samples with limited generalizability. Only a few studies, using a prospective design have implicated parenting styles, including low warmth and low monitoring, in eating pathology (Berge et al., 2010, Zubatsky et al., 2015). Yet other studies have suggested the effects of parental and family influences are as strong as other factors such as depression, peer pressure and body dissatisfaction (Lyke and Matsen, 2013, Paxton et al., 2006).

Importantly, little is known about the interaction between parenting practices in relation to eating pathology. This is surprising given that the practices of warmth and monitoring exist in all combinations across family structures within populations (Baumrind, 1975). Neglectful-disengaged parenting has been associated with a mixture of internalizing and externalizing negative health outcomes in adolescence, including depression (Katz et al., 2014), emotional distress (Operario, Tschann, Flores, & Bridges, 2006), conduct disorder (Racz & McMahon, 2011) and eating pathology (Berge et al., 2014). However, little is known about other forms of interactions between parenting styles. Yet, identification of such interactions has the potential to define important sub-populations of those most at risk and to more accurately target preventive interventions (Berge et al., 2014).

The purpose of this study was to examine relationships between parent-reported parental warmth and monitoring, and their interaction, in early adolescence (age 13–14) and subsequent risk of disordered eating behaviours in mid-adolescence (age 15–16). Data were drawn from a large population based longitudinal study that has followed the social and emotional development of over 2000 participants and their families from birth in 1983 across 30 years (15 waves) of data collection: The Australian Temperament Project (ATP).

Section snippets

Participants

Data are based on 1300 parents and offspring who participated in the ATP between early and mid-adolescence. The ATP has followed the social and emotional development of a large population-based cohort from infancy (4–8 months) to adulthood (27–28-years) across three decades (15 waves) since 1983. The initial sample comprised 2443 infants and their parents and were from urban and rural areas of the state of Victoria, Australia. Details on sample characteristics and sampling are provided in

Descriptive statistics for parental practices and disordered eating

The means and standard deviations (SD) and range of scores for the key variables are presented separately for males and females in Table 2. The mean value of parental warmth and monitoring was higher in males than females. Conversely, more females than males reported body dissatisfaction, drive for thinness and bulimia.

Table 3 presents frequencies for exposure (warmth and monitoring) and outcome variables (eating pathology) used in regression models. Low parental monitoring was more common in

Discussion

This study examined the main and additive interaction effects of low parental warmth and low monitoring on disordered eating in a large sample of Australian adolescent girls and boys. There was little evidence that low parental warmth and monitoring in isolation increased the risk of disordered eating in either girls or boys. For girls, the only significant main effect was found for low parental warmth in relation to bulimic behaviour. There were no main effects for boys. However, there was

Conclusions

Using unique data from a large population based cohort study (the ATP), this study aimed to provide a deeper understanding of how parenting practices may be related to risk for disordered eating attitudes and behaviours in female and male adolescents. Our results suggest that for girls, risk for bulimic behaviour is increased in those living with a low warmth parent and that risk for body dissatisfaction and drive for thinness is increased in those living with a low warmth and low monitoring

Authors contributions

IK, RK, AS and CO drafted the manuscript and conceptualized the aims and hypotheses. GY conducted the analyses and helped revise the manuscript. CO, and PL set up data collection and obtained funding for the project. EW contributed to measurement selection related to body dissatisfaction and disordered eating. EW, DLG and EH provided feedback on different versions of the manuscripts. All authors read and approved the final manuscript.

Acknowledgements

CO is supported by an ARC Principal Research Fellowship [DP1311459]. The ATP study is located at The Royal Children’s Hospital Melbourne and is a collaboration between Deakin University, The University of Melbourne, The Australian Institute of Family Studies, The University of New South Wales, The University of Otago (NZ), and the Royal Children’s Hospital; further information available at www.aifs.gov.au/atp. The views expressed in this paper are those of the authors and may not reflect those

References (60)

  • S.O. Hughes et al.

    Parent emotional distress and feeding styles in low-income families. The role of parent depression and parenting stress

    Appetite

    (2015)
  • I. Krug et al.

    A new social-family model for eating disorders: a European multicentre project using a case-control design

    Appetite

    (2015)
  • J. Lyke et al.

    Family functioning and risk factors for disordered eating

    Eating Behaviours

    (2013)
  • A.E. Mellin et al.

    Unhealthy behaviors and psychosocial difficulties among overweight adolescents: the potential impact of familial factors

    Journal of Adolescent Health

    (2002)
  • G.L. Mitchell et al.

    Parental influences on children’s eating behaviour and characteristics of successful parent-focussed interventions

    Appetite

    (2013)
  • D. Operario et al.

    Brief report: associations of parental warmth, peer support, and gender with adolescent emotional distress

    Journal of Adolescence

    (2006)
  • J.A. Saltzman et al.

    Parent binge eating and restrictive feeding practices: indirect effects of parent’s responses to child’s negative emotion

    Eating Behaviours

    (2016)
  • G.W. Stuart et al.

    Early family experiences of women with bulimia and depression

    Archives of Psychiatric Nursing

    (1990)
  • A. Tetley et al.

    Parental bonding and eating disorders: a systematic review

    Eating Behaviours

    (2014)
  • S. Akgul et al.

    The understanding of risk factors for eating disorders in male adolescents

    International Journal of Adolescent Medecine and Health

    (2016)
  • D. Baumrind

    The contributions of the family to the development of competence in children

    Schizophrenia Bulletin

    (1975)
  • P.R. Benson et al.

    Marital quality and psychological adjustment among mothers of children with ASD: cross-sectional and longitudinal relationships

    Journal of Autism and Developmental Disorders

    (2011)
  • J.M. Berge et al.

    The unique and additive associations of family functioning and parenting practices with disordered eating behaviors in diverse adolescents

    Journal of Behavioral Medicine

    (2014)
  • E.H. Blodgett Salafia et al.

    Longitudinal examination of maternal psychological control and adolescents’ self-competence as predictors of bulimic symptoms among boys and girls

    International Journal of Eating Disorders

    (2009)
  • L.D. Botto

    Flavors in gene-environment interactions

    Epidemiology

    (2007)
  • L.D. Botto et al.

    Commentary: facing the challenge of gene-environment interaction: the two-by-four table and beyond

    American Journal of Epidemiology

    (2001)
  • C.M. Bulik et al.

    Outcome of anorexia nervosa: eating attitudes, personality, and parental bonding

    International Journal of Eating Disorders

    (2000)
  • L. Canetti et al.

    Anorexia nervosa and parental bonding: the contribution of parent-grandparent relationships to eating disorder psychopathology

    Journal of Clinical Psychology

    (2008)
  • K.M. Culbert et al.

    Research review: what we have learned about the causes of eating disorders - a synthesis of sociocultural, psychological, and biological research

    Journal of Child Psychology and Psychiatry and Allied Disciplines

    (2015)
  • A.E. Field et al.

    Prospective associations of concerns about physique and the development of obesity, binge drinking, and drug use among adolescent boys and young adult men

    JAMA Pediatrics

    (2014)
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